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  • Fusion, flexibility, bending, what to expect

    Diagnosed with scoliosis at 14. Milwaukee brace from 17-18, didn't help. Chiropractic and muscle stimulation for years. Didn't inhibit activities or flexibility til late 30's. Was thoracic curve of about 20, lumbar curve in 40s. Now thoracic curve of 52, lumbar curve of 68. Discs in low lumbar/sacrum have completely degenerated and formed arthritic spurs causing pain and burning sensation. I cannot walk or stand for long periods and I have a lot of sciatic pain down my left leg.

    Saw ortho surgeon in mid 70s. Refused fusion for many reasons. Saw Dr Lebwohl in Miami 5 years ago. He recommended low lumbar/sacral fusion followed by a later fusion on rest of back. Saw Dr Moreno in Tampa recently. Curves have increased 10 degrees in 5 years, he recommends full fusion of entire back. (Have requested T&L numbers, will post later).

    My pain is not horrendous, but has increased from mild discomfort 10 years ago to more constant pain and decreased function. Plus, my list to the left has become very bad and I now limp. Both surgeons have told me I need the surgery, but could put it off a few years. Of course there's the magic number when the curve gets too bad to successfully correct.

    This is the first time I've had really good insurance and a job that's slow in the summer so I can take off for a month. I can also work part time or from home. My kids are 12 and 14 and will be home/won't start school til 11 days after Aug 13 surgery. Also have support of mom and husband. So the timing is good.

    My real concern is mobility after. Flexibility. Being able to turn when driving. Snow skiing, waterskiing, walking. Sex. Tying my shoes. I'd really like a first hand idea of what to expect from those that have done it. I'm 43 and otherwise healthy. Many thanks!
    Last edited by johnsonbunch; 07-15-2009, 03:59 PM.
    Sandy

    Thoracic curve was 55 degrees, now 30
    Lumbar curve was 68 degrees, now 26
    Rib rotation was 17 degrees, now 0
    Degenerated discs and sacral arthritic spurs, plus significant spondylosis
    Fused 8/13/09 at age 43 from T-9 to pelvis with iliac screws anchoring hardware to the pelvis, plus osteomies by Drs. Anthony Moreno and Geoff Cronen, Tampa, FL

  • #2
    Originally posted by johnsonbunch View Post
    My real concern is mobility after. Flexibility. Being able to turn when driving. Snow skiing, waterskiing, walking. Sex. Tying my shoes. I'd really like a first hand idea of what to expect from those that have done it. I'm 43 and otherwise healthy. Many thanks!
    Hi,

    I guess you don't know what levels you would be fused. I was fused 9 months ago (today) from T3 to L3, and I'm 47 yrs old. My doctor did tell me no skiing for one year (but then I've never skied and don't intend to start now.) Instead of twisting when I drive, I have leather seats so I turn my whole body from my butt and I manage just fine. Walking--I can walk 5 miles at a shot and I've done so since about 4 months post-op. I've been able to tie my own shoes since a month post op. I just pull my foot on top of the other knee and it works just fine. Sex--not a problem. I think we first tried too soon, even though the dr. said we could. I had a problem--um--that nothing 'worked' for me at first, but I think it was the pain meds. Also at first I felt like I was getting crushed, but I think that's because it was early on. Since about 6 months post-op, we've been just FINE. Send me a PM if you have more questions on that topic.

    This is just my experience, but no way could I have gone back to work in one month. I think probably I could have at 3 or 4 months, but not any sooner. I was just too exhausted.

    Good luck and ask any questions you have.
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

    Comment


    • #3
      The amount of flexibility you'll lose is really a function of which levels will be fused. In most cases for us "older" adults, the loss of flexibility isn't as noticeable as one would expect. When there's a painful disc, we do a lot unconsciously to avoid using that level, so you're already somewhat limited in at least part of the area that will be fused.

      Regards,
      Linda
      Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
      ---------------------------------------------------------------------------------------------------------------------------------------------------
      Surgery 2/10/93 A/P fusion T4-L3
      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

      Comment


      • #4
        Fusion, Flexibility, What to Expect

        I'm 55 (56 next month), and had my first surgery in Apr 08. I was fairly limber before the surgery and walked 1.5 miles on my treadmill and did Pilates on my Pilates Premier. I am fused T2 to S2. I pretty much quit pain meds just a couple of days after I got home from the hospital (8 days total in hospital, 4 days regular hospital, 4 days rehab hospital). I wore my TLSO (ninja turtle suit), for about six weeks. I went back to work part-time in July, did not return to work full time, until my retirement in Dec 08. I took pain meds when I hurt, and usually only at night. I had a second surgery in Nov 08, removing the clamp at around T4-T6 (not sure where), and missed work for about one week. I had my third (and last, I hope), surgery in Mar 09. I had a fracture at T3 because the screw was too big and fusion had never taken place there. So I'm recovering from that. I was able to tie or buckle my shoes at about three-four months. I usually put my ankle over my opposing knee and put on shoes and socks with no assistance. I did need help with bathroom personal hygiene, and my husband was my helper. He really would do anything for me! Sex, well, we've been married for over 31 years now, and it's all new for both of us! Any other questions, PM me, please! I also just spin on my butt to see behind me as I back my car. If I put something on the floor next to my feet, I will have to stand up and pick it up. I can't just bend over and reach it like I used to. All of the flexibility issues I had have been resolved with adaptation. You'll be amazed how quickly you adapt to what you can't do as far as flexibility. Good luck and keep us posted. I would recommend you keep a journal, as it is fun to go back and look at your progress daily. I did not do so, and wish I had.

        I am back to doing treadmill and Pilates. There are some exercises I can't to, but, I've incorporated new ones, such as squats and lunges to improve my flexibility and stamina, thanks to my physical therapist.

        Hugs,
        Les
        Les, Biker Babe, age 56 (at time of first surgery)
        Fused T2 to S2, posterior only, 8 Apr 08
        T3 fracture repair and revision, Mar 09
        Broke left lower rod and pelvic screws removal, Dec 09
        Scheduled to remove all hardware, replaced everything instead due to non-fusion, Nov 10
        Remove top 2" of rods and screws, Feb 14
        Pre surgery degrees: L40, T45
        Post surgery degrees: L8, T10

        Happy, joyous and pain-free!
        Surgeon: C Timothy Floyd, MD, Boise Orthopedic Clinic

        Comment


        • #5
          I can't add much more to the replies above except to say, although there are a very few things I can't yet do (at 4 months) I compare that to having a pain-free back, feeling great and hopefully, no worries with my scoliosis into the future. Even if I can never trim my toenails or put my socks on, it's been well worth it.

          As for your timing, it sounds like now is the perfect time. Will such a time arise again in the future?

          Good luck!
          Surgery March 3, 2009 at almost 58, now 63.
          Dr. Askin, Brisbane, Australia
          T4-Pelvis, Posterior only
          Osteotomies and Laminectomies
          Was 68 degrees, now 22 and pain free

          Comment


          • #6
            Your flexability will be like when you were pregnant. You probably have already made a lot of adjustments due to pain. When it comes to driving - don't drive while taking pain medicine. If you get stopped, it is a DUI!!! My daughter was fused at 14. She took her driving test at 16. She cannot twist to backup. She uses her mirrors. She explained her situation to the test giver and was told she had to twist. She did slightly and ran over cones. She did it again using her mirrors and was fine. They passed her. She is a great driver - very careful.
            T12- L5 fusion 1975 - Rochester, NY
            2002 removal of bottom of rod and extra fusion
            3/1/11 C5-C6 disc replacement
            Daughter - T7 - L3 fusion 2004

            Comment


            • #7
              flexibility

              Sounds like you have a situation there that definitely needs attention! Your children are at a great age to help out and if your parents are willing to lend a hand now might be your time. However, like someone else said, working after one month probably isn't realistic. I am a stay at home mom and can't even imagine having to go back to work at 3 months post op but I know that lots of people have to.

              Like you, I had 3 degenerated discs in my lumbar region, a significant amount of rotation with all my vertebre and a 5 centimeter shift to the left. I had a lot of pain for 5 years and can tell you it was so worth it....even with the set backs. I was very flexible prior to surgery so for me I don't really feel fused. Which isn't neccessarily a good thing because I have just recently had my first set back and I think I bent or twisted and didn't even realize it. My muscles are reminding me though I can promise you that! Everyone is different. But any loss of flexibility is worth it compared to the pain you have to deal with. You just find new ways to do things:O) just be creative
              Susan

              Diagnosed at 10, Boston brace from 11-13 yrs old.
              50* Lumbar w/ 5 centimeter shift to the left and slight rib hump...
              Surgery Date: April 15 and April 22, 2009
              X-LIF approach for disc repair L5,L4,L3,L2
              Posterior Approach for fusions L5-T5
              Dr. Fox @ Naval Medical Center Portsmouth
              Nice and straight now!!!!!

              Comment


              • #8
                Iliac screws

                I also have a lot of rotation in mid back, and my sacrum is tilted in the pelvis from the degeneration.

                I think my fusion will be most like Les as far as going to the sacrum. The doc says he'll fuse T-2 to the pelvis and anchor the instrumentation to the pelvis with iliac screws, pictured. He'll also do osteotomies (trimming bone in some vertabrae and my arthritic spurs). I can't imagine how I could move at all looking at that diagram!
                Last edited by johnsonbunch; 07-16-2009, 02:29 PM.
                Sandy

                Thoracic curve was 55 degrees, now 30
                Lumbar curve was 68 degrees, now 26
                Rib rotation was 17 degrees, now 0
                Degenerated discs and sacral arthritic spurs, plus significant spondylosis
                Fused 8/13/09 at age 43 from T-9 to pelvis with iliac screws anchoring hardware to the pelvis, plus osteomies by Drs. Anthony Moreno and Geoff Cronen, Tampa, FL

                Comment


                • #9
                  Hi Johnsonbunch...

                  You'll find a bunch of people who had very similar surgeries, here:

                  http://health.groups.yahoo.com/group/Flatback_Revised/

                  Regards,
                  Linda
                  Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                  ---------------------------------------------------------------------------------------------------------------------------------------------------
                  Surgery 2/10/93 A/P fusion T4-L3
                  Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                  Comment


                  • #10
                    This is not a revision and I don't have flatback, so I posted in the Scoliosis Medical group.
                    Sandy

                    Thoracic curve was 55 degrees, now 30
                    Lumbar curve was 68 degrees, now 26
                    Rib rotation was 17 degrees, now 0
                    Degenerated discs and sacral arthritic spurs, plus significant spondylosis
                    Fused 8/13/09 at age 43 from T-9 to pelvis with iliac screws anchoring hardware to the pelvis, plus osteomies by Drs. Anthony Moreno and Geoff Cronen, Tampa, FL

                    Comment


                    • #11
                      Originally posted by johnsonbunch View Post
                      This is not a revision and I don't have flatback, so I posted in the Scoliosis Medical group.
                      Sorry, didn't mean to imply that you were in the wrong place. The reason I posted the link is that many of the people in that group have long fusions to the pelvis, and can talk to you about the flexibility issue.

                      --Linda
                      Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                      ---------------------------------------------------------------------------------------------------------------------------------------------------
                      Surgery 2/10/93 A/P fusion T4-L3
                      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                      Comment


                      • #12
                        Johnson Bunch--Yours is almost exactly like mine: T2-pelvis, also had 6 osteotomies and 2 cages. I was encouraged by Dr. Lenke to try more bending at my 3 month although still get mixed signals on that. I find it very confusing. But I am trying to do more than before. It's hard to know how much is too much. Janet
                        Janet

                        61 years old--57 for surgery

                        Diagnosed in 1965 at age of 13--no brace
                        Thoracic Curve: 96 degrees to 35 degrees
                        Lumbar Curve: 63 degrees to 5 degrees
                        Surgery with Dr. Lenke in St. Louis--March 30, 2009
                        T-2 to Pelvis, and hopefully all posterior procedure.

                        All was posterior along with 2 cages and 6 osteotomies.

                        Comment


                        • #13
                          Janet Doodles,
                          Can you turn? When you bend over is it only from your hips? How hard is it to put on pants, shave your legs or pick something off the floor?
                          Sandy

                          Thoracic curve was 55 degrees, now 30
                          Lumbar curve was 68 degrees, now 26
                          Rib rotation was 17 degrees, now 0
                          Degenerated discs and sacral arthritic spurs, plus significant spondylosis
                          Fused 8/13/09 at age 43 from T-9 to pelvis with iliac screws anchoring hardware to the pelvis, plus osteomies by Drs. Anthony Moreno and Geoff Cronen, Tampa, FL

                          Comment


                          • #14
                            At 3 1/2 months I'm doing a lot more than I was a few weeks ago. I still don't twist. If I need to see something behind me I stand up and turn around. I have only done in-town, small-town driving so that's OK. I'm not anxious to get on an interstate however. I was told I could bend more and have done that. Also I often just go down on one knee--but not very often. I'm still using my reacher a lot. I used it at first to put on pants, etc. but I don't need to anymore. I attached my razor to a long wooden spoon and can put my leg up on the bench thing in the shower now and can do it pretty well. I didn't attempt that for quite a while though. Hope this helps. I guess I have to be bending from the hips--I think the waist is impossible for me. These were definitely my biggest worries also but I'm finding you do find ways to cope. Toe nails--can't get there yet at all. That could be way off in the future. Janet
                            Janet

                            61 years old--57 for surgery

                            Diagnosed in 1965 at age of 13--no brace
                            Thoracic Curve: 96 degrees to 35 degrees
                            Lumbar Curve: 63 degrees to 5 degrees
                            Surgery with Dr. Lenke in St. Louis--March 30, 2009
                            T-2 to Pelvis, and hopefully all posterior procedure.

                            All was posterior along with 2 cages and 6 osteotomies.

                            Comment

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